Td, Tdap, Dt, Dpt, Dtap???

My patient needs a tetanus shot — what kind do I give??Read more


70yoM with headache and R temporal artery tenderness.Read more

Fever and Tremor

38yoF with hypothyroidism prevents with drowsiness, palpitations and tremors. Pt with fever  to 38C, Hr to 120.Read more

Fractures and Nerves

Board review: fractures/dislocations and associated nerve injuries: Acetabular fracture – sciatic nerve Anterior shoulder dislocation – axillary and musculocutaneous nerve Humerus – radial nerve Elbow dislocation – ulnar or median nerve Olecranon fracture – ulnar nerve Supracondylar fracture – median, radial or ulnar nerve Hip dislocation Anterior – femoral nerve Posterior – sciatic nerve KneeRead more

Clinical Picture

A 4 year old boy presents with the above findings. What is it and how do you treat it?Read more

Spine Injuries

Concerned about cervical cord injury in your trauma or MVA pt?Read more

Classic Pneumonia Associations

For Friday’s missed pearl:Read more

Retropharyngeal Abscess

  A 4-year-old boy comes to the ED with a severe sore throat and history of “refusing to eat”. He has severe pharyngitis on exam an you are concerned that he may have a retro pharyngeal abscess. What technique should be used to most accurately assess the prevertebral space on lateral neck X-ray? To avoidRead more

E M Pearl, June 1

Tip of the hat to Raj Patel for inspiring this clinical question.   26F h/o lupus is brought into resus for positive sepsis screen at triage.  Patient c/o pleuritic CP, SOB, headache, n/v starting today. Vitals are 101.3  140  74/55  24  96%. Patient is on prednisone for lupus. In addition initiating your work-up for infectiousRead more

E M Pearl, May 29

An 18 year old female presents to the peds ED after an episode of witnessed syncope. Pt was hiking when had sudden LOC, no preceding symptoms.  She now feels well and denies CP and palpitations. No prior episodes. No OCP use or other PE risk factors. Her vitals and exam are normal. Her EKG fromRead more